Injectable Fillers and the Oral Microenvironment: From Mucosal Reactions to Implant Healing Failure: A Narrative Review

Background: Dermal fillers have become an integral part of facial aesthetics and are increasingly relevant to dental practice, particularly in the peri-oral region. While these agents restore volume and improve soft tissue contours, their interaction with oral tissues and dental implants presents important clinical challenges. Complications such as mucosal inflammation, delayed granulomatous reactions, filler migration, and biofilm-associated infections have been reported, with growing evidence that filler-induced reactions may mimic or exacerbate peri-implant diseases. Understanding these mechanisms is vital as the demand for combined restorative and aesthetic procedures continues to rise. Objective: This narrative review aims to explore the interplay between dermal fillers and the oral microenvironment, with a focus on short- and long-term complications, the role of oral microbiota and biofilm in infection risk, and their potential to compromise implant osseointegration and peri-implant health. Main Discussion Points: The review synthesizes evidence on filler classification, pathophysiological mechanisms of adverse events, and common oral/perioral complications. It further examines how biofilm formation contributes to persistent infection and delayed healing, and highlights diagnostic difficulties when filler-induced inflammation overlaps with peri-implantitis. Emerging management strategies, including ultrasound guidance and photodynamic therapy, are discussed alongside preventive measures such as careful patient selection, dental screening, and appropriate procedure timing. Conclusion: Dermal fillers, though effective in enhancing facial aesthetics, may adversely impact oral tissues and implant success through inflammatory and infectious pathways. Multidisciplinary collaboration between dental and aesthetic specialists, combined with long-term surveillance and evidence-based protocols, is essential to improve safety, optimize treatment outcomes, and guide future research in this evolving field.